Sakamoto T, Tei C, Hayashi T, Ichiyasu H, Amano K, Hada Y, Serizawa T
Jpn Heart J. 1977 Nov;18(6):883-95.
The mechanism of production of pulsus paradoxus was echocardiographically studied in a 74-year-old male with subacute effusive-constrictive pericarditis which developed to constrictive pericarditis under the observation. Echocardiography disclosed the following phenomena during inspiration: 1) mitral valve did not open until the atrial systole, probably because of the lack of antegrade mitral flow during rapid filling phase (the E wave was not observed), 2) concomitantly, aortic valve opening decreased markedly in its grade, and 3) left ventricular ejection time (LVET) decreased and pre-ejection period (PEP) increased, resulting in a higher PEP/LVET ratio (up to 1.32). The opposite was true during expiration (PEP/LVET ratio was 0.40). This is probably the first case, in which the mechanism of pulsus paradoxus was investigated by aortic and mitral valve echograms.
对一名74岁男性亚急性渗出性缩窄性心包炎患者进行了超声心动图研究，观察期间该患者发展为缩窄性心包炎，研究其奇脉产生机制。超声心动图显示吸气时出现以下现象：1）二尖瓣直到心房收缩才开放，可能是因为快速充盈期二尖瓣前向血流缺乏（未观察到E波）；2）同时，主动脉瓣开放程度明显降低；3）左心室射血时间（LVET）缩短，射血前期（PEP）延长，导致PEP/LVET比值升高（高达1.32）。呼气时情况相反（PEP/LVET比值为0.40）。这可能是首例通过主动脉瓣和二尖瓣超声心动图研究奇脉产生机制的病例。
